| NPI | 1396402889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2021-0124) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: WA PA61489173) | |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2024-07-16 |